SPECIAL REPORT: Despite Several Budget Allocations, Rural Community Still Battles Communicable Diseases

Who are you? Who sent you to me? How did you get to know me? Mrs Joe reacted aggressively when she met with our reporter due to fear of stigmatisation and victimisation.”

Mrs Joe (name changed), a mother of two, had barely survived a cholera infection last year November in the AbuleOtun community, after cases reportedly broke out, leaving her to go into isolation for weeks of treatment.

Unfortunately, Mrs Joe was not the only infected victim of the outbreak. Several cases were confirmed to have emanated from the two-story building occupied by over 20 families where she lives.

Mrs Joe, like every other resident in the community, depends on well-water for drinking, cooking and bathing. The well is 10 feet away from their toilet pit and a stagnant gutter channel.

Mrs Joe was said to have resumed her daily market trade when symptoms of the infection started. Barely a few hours after persistent stooling and vomiting, she was rushed to the state hospital for treatment.

AbuleOtun Community came into limelight in November 2019 after five persons including a four-month-old baby and a 33-year-old woman reportedly died from a cholera outbreak in Ogun State.

The community, under the Abeokuta North local government, is directly beside the Ogun river. It is divided into two parts; Ifesowapo and AbuleOtun, with major entrances from Lafenwa market and Brewery bus point, respectively.

About 40 per cent of the residents of the community are over 50 years old and the majority of them are involved in household trading, selling of food and food items, household relief materials and other artisan skills to sustain a livelihood.

Findings by this reporter revealed that over 70% of residents living in AbuleOtun survive on well-water despite two major Local government water projects constructed by their senatorial representative to provide clean water for the community. This water system, according to observations, stopped functioning to its full capacity and only supplies water twice in a week within a few hours of operation.

Alternatively, the well-water is used for cooking, washing and bathing without any hygienic prevention. With its closeness to Ogun river, water sourcing underground is at 15feet maximum. This advantage gives almost all houses in the community the privilege to own a well.

However, residents would prefer to alternate well-water for the state government’s water supply as the pipes constructed to provide clean water in various houses are either damaged or contaminated. 

Aside from having an unhygienic water system, the community battles with several environmental challenges including flooding from the Ogun river, improper waste disposal, open defecation, a poor drainage system and channels, and a generally polluted environment. These challenges, in turn, spur the spread of communicable diseases and infections like malaria, cholera, measles, fever, pox and diarrhoea.

Battling With Illness In AbuleOtun

The first point of reference for medical care in the community is a partially completed private maternity hospital located at the centre of the community.

Oluwaseun Maternity Home was established to provide health care services for pregnant women and nursing mothers.

However, the hospital is now compelled to extend its services to cover recommendations and treatment of malaria, measles, pox and fever for affected residents after daily complaints persisted.

The Head Doctor, Dr Tolu, who spoke exclusively, said that the hospital admits and offers treatments to residents with malaria, fever and measles, weekly, adding that children and pregnant women suffer front line infections due to the environmental hazards.

“We majorly deal with pregnant women because this is a maternity centre. However, because of the peculiarity of the community, we can also provide care to those who have fever, malaria and other diseases.

“This is, however, based on recommendations because most people at first would self medicate themselves. When the illness persists, they visit the hospital and if it becomes worse, we refer them because we are limited in facilities.

“Within a week, we could treat about ten or more patients with these diseases. This is as a result of the environmental challenges and poor hygiene the community faces. We can’t bill them very high, obviously, no money for them to get those expensive drugs, they would rather alternate it for a cheaper one they can afford.”

Records from the community’s patronized pharmacies confirmed that between 7-10 adults spend N500 to N1200 weekly on drugs. Similarly, between 7-10 children spend N300 to N700 weekly on drugs to treat communicable diseases caused by environmental challenges.

An adult is likely to spend between N6000 to N14000, yearly, buying drugs. This, however, excludes payments on test results, consultancy fee, feeding, hospital and admission charges.

Ogun Health Report

According to the Nigeria Centre for Disease Control (NCDC), across six diseases; cholera, CSM, Lassa fever, measles, monkey-pox and yellow fever, Ogun State had a record total of 486 cases between 2016 and 2019 despite the huge budget allocated for health care services.

Its worst-hit years were between 2018 and 2019 and these increases are not unconnected to the poor hygienic and environmental challenges of residents in the rural areas where cases are predominantly recorded.

In the 2018 budget of accelerated development, rural infrastructural development and efficient health, under the five-point cardinal programme, a total of N94.2 billion was allocated. The health sector had a capital expenditure of N12.0bn while over N8.0bn was earmarked to manage the public health services, yet, there were increasing cases of yellow fever.

Money was also allocated for environmental protection, community development, water supply with over N7.2bn, N700 million and N7.5bn in the budget, respectively. 

In the final schedule in 2019, the Public Health Service received a total of N103 million, Ogun State Water Corporation received N300 million, while the Ministry of Environment received a total of N500 million for its total expenditure contained in the N400bn approved budget.

With these yearly allocations, BudgIT, in its 2020 state of state report noted that 26% of the state population does not have access to an improved source of water, while 23% still practice open defecation. 

The state recorded outbreaks of cholera and measles with 14 and 452 cases in 2019, respectively. Similarly, cases of yellow fever rose to 35 in 2018 against its index case of 11 persons in 2017.

Despite having one of the lowest disease outbreaks in the southwest, the state pays less attention to improving the sanitation of rural areas which, in turn, puts residents at high risk of contracting communicable diseases and infections.

This story was supported by the US Embassy via the ATUPA Fellowship by Civic Hive